论文部分内容阅读
目的:探讨子宫颈癌根治术后高危患者同步放化疗与放疗+化疗序贯治疗、单纯放疗的疗效及毒副反应。方法:117例宫颈癌术后高危患者分为同步放化疗组、放疗+化疗序贯治疗组和单纯放疗组3组,各39例。3组放疗方案相同。第1组在放疗第1周内同时给予FP方案化疗;第2组在放疗结束后1周给予FP方案化疗。结果:3组3年盆腔复发率分别为2.6%、17.9%和23.1%,第1组与第2、3组比较差异有统计学意义,χ2=6.532,P=0.011;3组3年远处转移率分别为2.6%、12.8%和25.6%,第1、2组与第3组比较差异有统计学意义,χ2=6.936,P=0.008;3组3年生存率分别为94.7%、74.4%和61.5%,第1组与第2、3组比较差异有统计学意义,χ2=10.268,P=0.001。第1组骨髓抑制和消化道反应发生率均高于第2、3组,χ2值分别为14.204和13.882,P值均为0.000,但大部分患者能够耐受。结论:子宫颈癌术后高危患者同步放化疗组与放疗+化疗序贯治疗、单放组比较,降低了3年盆腔复发率,减少了3年远处转移率,提高了3年生存率,且早期毒副反应能耐受。
Objective: To investigate the curative effect and toxicity of concurrent radiotherapy and chemotherapy + radiotherapy and sequential chemotherapy in patients with high risk of radical cervical cancer after radiotherapy. Methods: One hundred and seventy-one high-risk patients with cervical cancer were divided into three groups: concurrent chemoradiotherapy group, radiotherapy + sequential chemotherapy group and radiotherapy alone group, with 39 cases in each group. 3 groups of the same radiotherapy program. In the first group, FP regimen was given in the first week of radiotherapy. In the second group, FP regimen was given one week after the end of radiotherapy. Results: The 3-year pelvic recurrence rates of 3 groups were 2.6%, 17.9% and 23.1% respectively. There was significant difference between group 1 and groups 2 and 3 (χ2 = 6.532, P = 0.011) The rates of metastasis were 2.6%, 12.8% and 25.6% respectively. There was a significant difference between group 1 and group 3 (χ2 = 6.936, P = 0.008). The 3-year survival rates were 94.7% and 74.4% And 61.5% respectively. The difference between the first group and the second group was statistically significant (χ2 = 10.268, P = 0.001). The incidence of bone marrow suppression and digestive tract reaction in group 1 were higher than those in groups 2 and 3, with χ2 values of 14.204 and 13.882, respectively. The P values were both 0.000, but most of the patients were tolerant. Conclusion: Compared with radiotherapy and chemotherapy sequential therapy, radiotherapy combined with radiotherapy and chemotherapy in patients with high risk of cervical cancer can reduce pelvic recurrence rate by 3 years, decrease distant metastasis rate by 3 years, and improve 3-year survival rate, And early toxic side effects can tolerate.